Digital health misinformation in Southeast Asia: a systematic review of susceptibility, public health consequences, and intervention evidence

Background Digital health misinformation forms part of the information environment in which people assess health risks and act on health advice. We systematically reviewed participant-level studies from Southeast Asia addressing susceptibility, public-health consequences, and intervention evidence. Methods We searched PubMed, Europe PMC, Web of Science Core Collection, and Scopus, supplemented by known reports from the original manuscript and publication-version checks. Prespecified eligibility criteria required primary empirical research involving Southeast Asian populations, an explicit health-misinformation focus, a documented digital connection, and participant-level outcomes. The search and selection process was reported according to PRISMA 2020. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT 2018). Heterogeneity in study designs, measures, and outcomes precluded meta-analysis; findings were synthesized narratively. Results The searches identified 2,210 database records; 1,142 remained after deduplication. Including supplementary identification, 282 reports were sought, 147 were assessed in full text, and 77 reports were included, representing 74 conservatively grouped study populations. Country-attributable evidence came from Indonesia, Malaysia, Singapore, the Philippines, Thailand, Vietnam, and Lao PDR; two further reports provided regional findings. Fifty-four reports concerned COVID-19. Appraisal and belief were associated with cognition, literacy, trust, identity, emotion, and social context, although measures and sampling differed considerably. Findings linked misinformation-related constructs with sharing, vaccine attitudes, preventive behavior, distress, and accounts of delayed care. Correction, inoculation, digital education, chatbots, and community responses produced heterogeneous findings; most interventions did not isolate a misinformation-specific behavioral effect. Discussion Interpretation is limited by 135 unretrieved reports, a single assessment workflow without independent duplicate human screening, and predominantly observational evidence. The regional literature supports context-sensitive interpretation of exposure, appraisal, belief, and action; it does not establish a uniform causal pathway or a preferred intervention transferable across all settings.